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How important are individual, household and commune characteristics in explaining utilization of maternal health services in Vietnam?

Listed author(s):
  • Sepehri, Ardeshir
  • Sarma, Sisira
  • Simpson, Wayne
  • Moshiri, Saeed

Using Vietnam's latest National Household Survey data for 2001-2002 this paper assesses the influence of individual, household and commune-level characteristics on a woman's decision to seek prenatal care, on the number of prenatal visits, and on the choice between giving birth at a health facility or at home. The decision to use any care and the number of prenatal visits is modeled using a two-part model. A random intercept logistic model is used to capture the influence of unobserved commune-specific factors found in the data regarding a woman's decision to give birth at a health facility rather than at home. The results show that access to prenatal care and delivery assistance is limited by observed barriers such as low income, low education, ethnicity, geographical isolation and a high poverty rate in the community. More specifically, more prenatal visits increase the likelihood of giving birth at a health facility. Having compulsory health insurance increases the odds of giving birth at a health facility for middle and high income women. In contrast, health insurance for the poor increases the likelihood of having more prenatal visits but has little effect on the place of delivery. These results suggest that the existing safe motherhood programs should be linked with the objectives of social development programs such as poverty reduction, and that policy makers need to view both the individual and the commune as appropriate units for policy targeting.

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Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 67 (2008)
Issue (Month): 6 (September)
Pages: 1009-1017

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Handle: RePEc:eee:socmed:v:67:y:2008:i:6:p:1009-1017
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  1. Celik, Yusuf & Hotchkiss, David R., 2000. "The socio-economic determinants of maternal health care utilization in Turkey," Social Science & Medicine, Elsevier, vol. 50(12), pages 1797-1806, June.
  2. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
  3. Ensor, Tim & Ronoh, Jeptepkeny, 2005. "Effective financing of maternal health services: A review of the literature," Health Policy, Elsevier, vol. 75(1), pages 49-58, December.
  4. Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Li-Mei, 2003. "National Health Insurance and the antenatal care use: a case in Taiwan," Health Policy, Elsevier, vol. 64(1), pages 99-112, April.
  5. Raghupathy, Shobana, 1996. "Education and the use of maternal health care in Thailand," Social Science & Medicine, Elsevier, vol. 43(4), pages 459-471, August.
  6. Anne Pebley & Noreen Goldman & Germán Rodríguez, 1996. "Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?," Demography, Springer;Population Association of America (PAA), vol. 33(2), pages 231-247, May.
  7. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," Review of Economic Studies, Oxford University Press, vol. 55(1), pages 85-106.
  8. Duong, Dat V & Binns, Colin W & Lee, Andy H, 2004. "Utilization of delivery services at the primary health care level in rural Vietnam," Social Science & Medicine, Elsevier, vol. 59(12), pages 2585-2595, December.
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